Brain tumours

Question 1

What are the primary brain tumours that arise in adults?

Answer 1

Glioblastoma multiforme
Oligodendroglioma
Meningioma
Hemangioblastoma
Pituitary adenoma
Schwannoma

Question 2

What is a gliobastoma multiforme?

Answer 2

Grade IV astrocytoma; a common and very malignant brain tumour with survival of about 1 year.

Question 3

Which is the most common adult primary brain tumour?

Answer 3

gliobastoma multiforme

Question 4

Where is a gliobastoma multiforme found?

Answer 4

In cerebral hemispheres and may cross corpus callosum

Question 5

What does a gliobastoma multiforme stain positive for?

Answer 5

+ GFAP (astrocyte origin)

Question 6

gliobastoma multiforme histology

Answer 6

pseudopalisading pleomorphic tumor cells border central area of necrosis, hemmorhage or microvascular proliferation

Question 7

What is an oligodendroglioma?

Answer 7

A rare slow growing tumour usually inthe frontal lobes

Question 8

oligodendroglioma histology

Answer 8

Fried egg appearnce of cells with chicken wire capillary pattern

Question 9

Which is the second most common primary brain tumour of adults?

Answer 9

meningioma

Question 10

Description of meningioma ?

Answer 10

Common and usually benign. Occurs near surface of brain in parasaggital region. Extra-axial and may have a dural attachment.

Question 11

Where do you most commonly find a meningioma?

Answer 11

surface of brain in parasaggital region

Question 12

presentation of meningioma

Answer 12

often asymptomatic but may present with seizures or focal neurological signs

Question 13

treatment of meningioma

Answer 13

resection or radiosurgery

Question 14

Which cell does a meningioma originate from?

Answer 14

arachnoid

Question 15

Meningioma histology

Answer 15

spindle cells concentrically arranged in whorled pattern. Psammoma bodies.

Question 16

Risk factor for meningioma

Answer 16

prior radiation to head

Question 17

Where do hemangioblastomas usually occur?

Answer 17

in the cerebellum

Question 18

which syndrome are hemangioblastomas associaed with

Answer 18

VHL syndrome

Question 19

what may a hemangioblastomas produce?

Answer 19

erythropoeitin –» secondary polycythemia

Question 20

hemangioblastoma histology

Answer 20

blood vessel origin - closely arranged thin walled-capillaries with minimal intervening parynchema

Question 21

Pituitary adenoma presentation

Answer 21

Bitemporal hemianopia and potentially symptoms from hormones if producing them (most commonly prolactin)

Question 22

Pituitary adenoma of lactotrophs presentation

Answer 22

overproduction of prolactin ->ammenhoria/galactorea, impotence and decreased libido in men, decreased bone density due to decreased estrogen in women

Question 23

Pituitary adenoma of somatotrophs presentation

Answer 23

acromegaly and gigantism

Question 24

Pituitary adenoma of corticotrophs presentation

Answer 24

ACTH excess -> cushing disease

Question 25

Pituitary adenoma of thyrotrophs presentation

Answer 25

hyperthyroidism

Question 26

treatment of pituitary adenoma

Answer 26

Dopamine agonists (bromocriptine, cabergoline), transphenoidal resection

Question 27

Schwannomas are usually found where?

Answer 27

cerebellopontinge angle - involving both VII and VIII

Question 28

How does a vestibular schwannomas present (one that effects CNVIII)

Answer 28

tinnitus and hearing loss

Question 29

What disease are schwannomas associated wtih?

Answer 29

NFII

Question 30

What do schwannomas stain positively for?

Answer 30

S100+ (schwan cell origin)

Question 31

Schwannoma histology?

Answer 31

biphasic, dense, hypercellular areas with spindle cells alternating with hypocellular and myxoid areas

Question 32

What are the childhood primary brain tumours?

Answer 32

``` Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma ```

Question 33

What is a pilocytic astrocytoma?

Answer 33

low-grade astrocytome, the most common brain tumour in kids. Well-circumscribed with good prognosis. Benign.

Question 34

Most common location for a pilocytic astrocytoma?

Answer 34

posterior fossa (cerebellum)

Question 35

histology of pilocytic astrocytoma

Answer 35

GFAP + (astrocyte origin), rosenthal fibers - eosinophilic corkscrew fibers . Cystic and solid

Question 36

what does pilocytic astrocytoma stain + for?

Answer 36

GFAP

Question 37

What is medulloblastoma?

Answer 37

most common malignant brain tumour of childhood. Commonly involve cerebellum.

Question 38

Presentation of medulloblastoma?

Answer 38

Can compress the 4th ventricle -> noncommunicating hydrocephalus ->headaches and papilledema.

Question 39

where may a medulloblastoma metastasize to?

Answer 39

spinal cord (drop metastasis)

Question 40

a medulloblastoma is a form of what?

Answer 40

primitive neuroectodermal tumour

Question 41

histology of medulloblastoma

Answer 41

homer-wright rosettes - small blue cells

Question 42

Where is an ependymoma found?

Answer 42

4th ventricle

Question 43

complication of ependymoma?

Answer 43

hydrocephalus

Question 44

ependymoma histology

Answer 44

perivascular pseudorosettes and rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus

Question 45

What is a craniopharyngioma?

Answer 45

Most common childhood supratentorial tumour

Question 46

What may a craniopharyngioma be confused with?

Answer 46

pituitary adenoma (both cause bitemporal hemianopia)

Question 47

What is a craniopharyngioma derived from?

Answer 47

remnants of Rathke pouch (ectoderm)

Question 48

histology of craniopharyngioma

Answer 48

calcification may be seen | Cholesterol crystals found in motor oil like fluid within tumour

Question 49

what is a pinealoma?

Answer 49

tumour of the pineal gland that may cause parinaud syndrome

Question 50

which syndrome may a pinealoma cuase?

Answer 50

parinaud (compression of tectum -> gaze palsy)

Question 51

presentation of pinealoma

Answer 51

patient cant look up, pseudo argyll robertson pupils, obstructive hydrocephalus and precocious puberty in males (may production hcG)